- AmeriHealth Caritas (Washington, DC)
- …SW, Suite 1000, 10th Floor, Washington, DC 20024 **Responsibilities:** The Managed Care Provider Network Resolution Analyst is responsible for configuration ... providers in our network .; The Managed Care Provider Network Resolution Analyst ensures...+ One to two (1 - 2) years of Medicaid experience preferred. + Three (3) years in the… more
- Humana (Alexandria, VA)
- …management for network providers in Humana's Healthy Horizons in Virginia Medicaid Plan. This role supports provider onboarding, training, education, and ... positive provider experience with Humana Healthy Horizons and promote network retention + Meet regularly, both in-person and virtually, with assigned providers… more
- Intermountain Health (Washington, DC)
- …stays current and conversant on general plan design and modifications to provide accurate and appropriate information. This position maintains the confidentiality of ... status, and the formulary transition process. + Assists Medicare and Medicaid members with grievances, coverage determination (including exceptions), and appeals… more
- Cardinal Health (Washington, DC)
- …long and short-range changes in the reimbursement environment including Medicare, Medicaid , Managed Care, and Commercial medical and pharmacy plans while planning ... + Support team with call overflow and intake when needed + Mediate effective resolution for complex payer/pharmacy issues towards a positive outcome + First point of… more
- Cardinal Health (Washington, DC)
- …healthcare provider offices, SPs, and customers, striving for one-call resolution . + Mediate effective resolution for complex payer/pharmacy issues toward ... product in a timely manner. + Process enrollments via inbound fax, phone, and electronically. + Provide world-class service and receive inbound calls from patients,… more
- Cardinal Health (Washington, DC)
- …healthcare provider offices, SPs, and customers, striving for one-call resolution **Qualifications:** + 2-4 years of industry experience with patient-facing or ... Help patients understand their insurance plan coverage, including out-of-pocket costs, and provide guidance on the appeals process if needed + Resolve patient's… more
- Cardinal Health (Washington, DC)
- …database for the inquiry + Make all outbound calls to patient and/or provider to discuss any missing information and/or benefit related information + Notify ... process is complete + Assess patient's financial ability to afford therapy and provide hand on guidance to appropriate financial assistance + Must follow through on… more
- Cardinal Health (Washington, DC)
- …database for the inquiry. + Make all outbound calls to patient and/or provider to discuss any missing information and/or benefit related information. + Assess ... patient's financial ability to afford therapy and provide hand on guidance to appropriate financial assistance. +...based upon region and ensure proper communication of the resolution within required timeframe agreed upon by the client… more
- Cardinal Health (Washington, DC)
- …complete standard tasks + Works on routine assignments that require basic problem resolution + Refers to policies and past practices for guidance + Receives general ... Must demonstrate efficiency and strong organizational skill + Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate… more
- Cardinal Health (Washington, DC)
- …for handling inbound and outbound calls, with ability to determine needs and provide one call resolution + Responsible for reporting adverse events within ... patient by controlling the patient conversation, educating the caller as they provide effective and efficient strategies and processes **Qualifications** : + High… more
- Cardinal Health (Washington, DC)
- …all encountered issues and steps to resolve the issue. + Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate. + ... healthcare management industry including Prior Authorizations, Appeals, Medicare Part D, Medicaid , Managed Care, and Commercial plans is preferred. + Experience with… more